Personality Disorders

By: Dr. Akmal Mostafa Kamal

Assistant Professor of Psychiatry, Faculty of Medicine, Cairo

University.

What Is a Personality?• Personality is a relatively stable and

enduring set of characteristic cognitive, behavioral and emotional traits.

• Over time, a person will interact with others in a reasonably predictable way.

• Personality changes with experience, maturity, and external demands in a way that promotes adaptation to the environment.

• It is affected by genetic and psychosocial factors.

The Trait Approach to Personality

•The trait approach to personality is one of the major theoretical areas in the study of personality.

•The trait theory suggests that individual personalities are composed broad dispositions.

•Consider how you would describe the personality of a close friend.

•Chances are that you would list a number of traits, such as outgoing, kind and even-tempered.

•A trait can be thought of as a relatively stable characteristic that causes individuals to behave in certain ways.

•Unlike many other theories of personality, such as psychoanalytic or humanistic theories, the trait approach to personality is focused on differences between individuals.

•The combination and interaction of various traits combine to form a personality that is unique to each individual.

•Trait theory is focused on identifying and measuring these individual personality characteristics.

•In 1936, psychologist Gordon Allport found that one English-language dictionary alone contained more than 4,000 words describing different personality traits.• He categorized these traits into three levels:

Gordon Allport’s Trait Theory

Cardinal Traits: •Traits that dominate an individual’s whole life, often to the point that the person becomes known specifically for these traits.

• People with such personalities often become so known for these traits that their names are often synonymous with these qualities.

Cardinal Traits: •Traits that dominate an individual’s whole life, often to the point that the person becomes known specifically for these traits.• People with such personalities often become so known for these traits that their names are often synonymous with these qualities.

•Consider the origin and meaning of the following descriptive terms: Freudian, Machiavellian, narcissism, Don Juan, etc.

•Allport suggested that cardinal traits are rare and tend to develop later in life.

• Central Traits:• The general characteristics that form the basic foundations of personality.

•These central traits, while not as dominating as cardinal traits, are the major characteristics you might use to describe another person.

•Terms such as intelligent, honest, shy and anxious are considered central traits.

• Secondary Traits:• Traits that are sometimes related to attitudes or preferences and often appear only in certain situations or under specific circumstances.

•Some examples would be getting anxious when speaking to a group or impatient while waiting in line.

Raymond Cattell

•Trait theorist Raymond Cattell reduced the number of main personality traits from Allport’s initial list of over 4,000 down to 171.• Mostly by eliminating uncommon traits and combining common characteristics. •Next, Cattell rated a large sample of individuals for these 171 different traits.

•Then, using a statistical technique known as factor analysis, he identified closely related terms and eventually reduced his list to just 16 key personality traits.

•According to Cattell, these 16 traits are the source of all human personality.

•He also developed one of the most widely used personality assessments known as the Sixteen Personality Factor Questionnaire (16PF).

Eysenck•Eysenck’s Three Dimensions of Personality.

•British psychologist Hans Eysenck developed a model of personality based upon just three universal traits:• • Introversion/Extraversion:

•Introversion involves directing attention on inner experiences, while extraversion relates to focusing attention outward on other people and the environment.

•So, a person high in introversion might be quiet and reserved, while an individual high in extraversion might be sociable and outgoing.

• Neuroticism/Emotional Stability:

•This dimension of Eysenck’s trait theory is related to moodiness versus even-temperedness.

•Neuroticism refers to an individual’s tendency to become upset or emotional, while stability refers to the tendency to remain emotionally constant.

Psychoticism:

•Later, after studying individuals suffering from mental illness, Eysenck added a personality dimension he called psychoticism to his trait theory.

•Individuals who are high on this trait tend to have difficulty dealing with reality and may be antisocial, hostile, non-empathetic and manipulative.

The Five-Factor Theory

The Five-Factor Theory of Personality•Both Cattell’s and Eysenck’s theory have been the subject of considerable research, which has led some theorists to believe that Cattell focused on too many traits, while Eysenck focused on too few.

•As a result, a new trait theory often referred to as the "Big Five" theory emerged.

•McCrae and Costa (1999) describe five trait characteristics of personality, which consist of a person's level of agreeableness, conscientiousness, extraversion, neuroticism, and openness.

•This five factor model of personality represents five core traits that interact to form human personality.

Agreeableness: Refers to how you interact with other

people, and it involves the level of intimacy you maintain in your personal relationships and how helpful and sympathetic you are.

Characteristics of an agreeable personality include trust, straightforwardness, altruism, compliance, modesty, and tender-mindedness.

Conscientiousness:• Refers to your work style. • It involves your general dedication to activities; how hard you work and how efficient and focused you are. •Conscientious people are typically competent, orderly, dutiful, achievement striving, self-disciplined, and deliberate.

Extraversion: Refers to how you express yourself.

This trait considers your sociability, positive emotionality, assertiveness, and activity or energy level.

If you are extraverted, you're probably warm, gregarious, assertive, active, seek excitement, and tend toward positive emotions.

Neuroticism:Refers to your emotional style.

It involves the extent to which you experience negative emotions such as worry, self-doubt, stress and tension.

Most neurotic personalities display anxiety, angry hostility, depression, self-consciousness, impulsiveness, or vulnerability (or some combination of these characteristics).

Openness: Describes your intellectual style - the extent to which you are open to new ideas and innovative approaches, and have an active imagination.

Some characteristics of openness include fantasy, appreciation of art, the tendency to have a variety of emotions, action (not reaction), and individual ideas and values.

•While most agree that people can be described based upon their personality traits, theorists continue to debate the number of basic traits that make up human personality.

•While trait theory has objectivity that some personality theories lack (such as Freud’s psychoanalytic theory), it also has weaknesses.

•Some of the most common criticisms of trait theory center on the fact that traits are often poor predictors of behavior.• •While an individual may score high on assessments of a specific trait, he or she may not always behave that way in every situation.

•Another problem is that trait theories do not address how or why individual differences in personality develop or emerge.

What is a Personality Disorder?

•A personality disorder is an extreme set of characteristics that goes beyond the range found in most people. •It could be defined as:•An enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual's culture.•It is pervasive and inflexible.•It has an onset in adolescence or early adulthood.•It is stable over time.

•A personality disorder is an extreme set of characteristics that goes beyond the range found in most people. •It could be defined as:•An enduring pattern of inner experiences and behavior that deviates markedly from the expectations of the individual's culture.•It is pervasive and inflexible.•It has an onset in adolescence or early adulthood.•It is stable over time.

Why Recognize Personality Disorders ?

•- In the psychiatric setting:•They are considered axis II disorders and can present concurrently with any other psychiatric disorders.•Their presence affects markedly the prognosis, compliance to treatment and choice of therapy.•They are egosyntonic in the majority of eases, i.e.. the patient does not think of them as maladaptive or bad.•They are either discovered during treatment, or the family complains of them.

Personality DisordersDSM groups personality disorders into three clusters:– Cluster A (Exhibits odd or eccentric behavior).– Cluster B (Exhibits dramatic, emotional, or erratic behavior).– Cluster C (Exhibits anxious or fearful behavior).

Cluster A (Exhibits odd or eccentric behavior)

– Paranoid Personality Disorder Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent.

– Schizoid Personality Disorder Pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings.

– Schizotypal Personality Disorder Pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior.

Cluster B (Exhibits dramatic, emotional, or erratic behavior)

– Antisocial Personality Disorder Pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years.

– Borderline Personality Disorder Pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts

– Histrionic Personality Disorder Pervasive pattern of excessive emotionality and attention seeking

– Narcissistic Personality Disorder Pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy

Cluster C (Exhibits anxious or fearful behavior)– Avoidant Personality Disorder Pervasive pattern of social inhibition, feelings of inadequacy, & hypersensitivity to negative evaluation.

– Dependent Personality Disorder Pervasive & excessive need to be taken care of that leads to submissive & clinging behavior & fears of separation.

– Obsessive Compulsive Personality Disorder Pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.